Virtual Care Appointment Form Template

About this template

If your healthcare practice offers e-visits to avoid in-person contact and prevent the spread of contagions, use this free Virtual Care Appointment Form to simplify the appointment booking process. To get started, simply customize the form to match your needs, embed it in your website or email a form link to patients, and watch your calendar fill up with appointments! Patients can easily provide their contact information, select which practitioner and method of telecommunication they’d prefer, choose their appointment date and time, agree to terms and conditions, and submit payment details. You’ll instantly receive appointment bookings in your secure Jotform account, with HIPAA compliance features on the upgraded plan.

You customize treatment for your patients — so why not do the same for your Virtual Care Appointment Form? Using our drag-and-drop Form Builder, you won’t need to do any coding to add form fields for medical information, file uploads, signatures, and more. You can even set up conditional logic to change appointment availability based on the doctor a user chooses! And feel free to integrate the form with 100+ integrations, including Google Calendar for creating events automatically and 30+ payment gateways for seamless payment processing. By making it easier for patients to book virtual appointments online, your Virtual Care Appointment Form will help your medical staff communicate with, respond to, and treat patients as quickly as possible.